Professional Documents
Culture Documents
for
COGNITIVEBEHAVIORAL THERAPY
with
with hosts
Jon Carlson, PsyD, EdD & Diane Kjos, PhD
Manual by
Randall C. Wyatt, PhD and Erika L. Seid, MA
Psychotherapy.net
Psychotherapy.net
COGNITIVE-BEHAVIORAL THERAPY
WITH DONALD MEICHENBAUM, PHD
Table of Contents
Tips for Making the Best Use of the DVD
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Discussion Questions
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Complete Transcript
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Meichenbaums Approach
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Psychotherapy Session
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Video Credits
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Meichenbaums Perspective on
Learning and Doing this Work
An Invitation to a Journey of Healing
by Don Meichenbaum
I invite you to join me and a client as we begin a journey of healing. I
should mention at the outset that I love doing psychotherapy. Part of the
reason I love it so much is that I am totally enamoured with my head.
I really enjoy the way I think about clinical cases. I do not know if you,
the viewer, will share my psychotherapeutic approach and enthusiasm,
but I am having a field day.
Each client and each psychotherapy session provides the
psychotherapist with innumerable choice points. As you watch this
interview and the accompanying interviews with me, please put
yourself in my shoes. How would you go about achieving each of
the following therapeutic tasks that are demonstrated on the DVD?
How would you establish a respectful, empathic, genuine therapeutic
alliance? How would you help validate and normalize the clients
reactions? How would you assess for suicidal risk? How would you
help the client get in touch with her feelings (in this case her anger
toward her abusive father) and then come to see the connections
between her feelings, thoughts and behaviors? How would you help
nurture hope and have the client appreciate her strengths and survival
skills? In short, how would you help the client tell and begin to believe
the rest of the story of her resilience?
This film demonstrates how a constructive narrative perspective
can be combined with a cognitive-behavioral therapy approach in
facilitating a journey of healing. Envision what the next sessions should
include in helping this client turn her life around. What are all the
choice points for the client and the therapist?
Thank you for your interest. NOW ENJOY!
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www.psychotherapy.net
www.melissainstitute.org
www.aabt.org
www.nacbt.org
www.ocdaction.org.uk
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BOOKS
Meichenbaum, D. & Jaremko, M.E. (Eds) (1984). Stress reduction and
prevention. New York: Plenum Press.
Meichenbaum, D. (1977). Cognitive-behavior modification. New York:
Plenum Press.
Meichenbaum, D. (1985). Stress inoculation training. Elmsford, NY:
Pergamon.
Meichenbaum, D. (1987). Coping with stress. New York: Facts on File.
Meichenbaum, D. (1989). Exploring choices: The psychology of
adjustment. Glenview, IL: Scott Foresman & Co.
Meichenbaum, D. (1998). Nurturing independent learners: Helping
students take charge of their learning. Brookline, MA: Brookline
Books/Lumen Editions.
Meichenbaum, D. (2003). Treatment of individuals with anger-control
problems and aggressive behaviors. Carmarthen, UK: Crown
House Publishing.
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Discussion Questions
Professors, training directors and facilitators may use a few or all of
these discussion questions keyed to certain elements of the video or
those issues most relevant to the viewers. On-screen minute markers
are noted with some questions to highlight related points in the video/
transcript.
MEICHENBAUMS APPROACH
1. Thoughts, Feelings, Behaviors: What do you think about
Meichenbaums characterization of cognitive-behavioral therapy
(CBT) as an approach that focuses on the interconnection
between thoughts, feelings, behavior and resultant consequences?
Is this description consistent with your understanding of CBT?
Which aspects of Meichenbaums approach resonate with
you and your approach to psychotherapy? Which do not?
PSYCHOTHERAPY SESSION
2. History: (2-9 to 2-12) What do you observe about the way
Meichenbaum gathers information in this session? Are you
surprised by the focus on Beverlys history and the history of the
problem? What do you think about the relative balance between
focus on the past and on the present in this session? If you were
working with Beverly for only one session, would you have pursued
information about her childhood and her history with her father,
or would you have focused more exclusively on the present? Why?
3. The Critic: (2-15 to 2-18, 2-37 to 2-40) What do you think
about the way Meichenbaum works with Beverly on her
internal critic? What do you notice about how Beverly responds
to his comments and questions about the critic? In what
ways do you think he is or is not effective with her here?
4. Shoulds: (2-25 to 2-36) What are some of your reactions to
Meichenbaums interventions with the shoulds that Beverly tells
herself? What do you think about how the conversation about
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GROUP DISCUSSION
8. Structure: Meichenbaum covers a lot of territory in this session:
history, affect, psychoeducation, and concrete steps. What is
your sense of the rhythm and flow of the session? What do
you notice about how he structures the time and manages the
process that might be helpful to you in your own work?
9. Hands: (3-15) What specific observations do you have about
Beverlys hands in this session? What comes across to you
as a therapist when you see the video focus on her hands
at different points? In your own clinical work, what kind
of attention do you give to body language and other nonverbal cues, and how do you use these observations?
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Complete Transcript of
Cognitive-Behavioral Therapy
with Donald Meichenbaum, PhD
Note to facilitators: Throughout the transcript below, we indicate onscreen minute markers that correspond with those that appear in the
bottom right corner of the DVD on screen. You will find chapter markers
on the DVD at five-minute intervals so that you may easily skip to desired
points in the video.
MEICHENBAUMS APPROACH
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Dr. Jon Carlson: Diane, this program is going to be dealing with
cognitive-behavioral therapy. What do you know about cognitive
behavioral approaches?
Dr. Diane Kjos: Well, my sense is that this is based on the idea that
how we feel and how we behave has a lot to do with our thoughts or
how we perceive and think about things. So if we believe this, then
were going to behave this way. If we believe that, then were going to
feel that way that type of response.
Carlson: Its my understanding that theres a lot of different
approaches within cognitive therapy, too, so there really isnt just one
cognitive therapy approach. All of the approaches have similar things
in common. Like, they have a focus on working, looking at goals,
where people are headed. Its very time limited. Its a bio-psycho-social
approach, which really, you know, highlights the fact that we do work
with thinking, we do work with behaving but also a lot with feelings.
How does this relate to some of the other theories?
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Kjos: I think its really based on the earlier research in terms of
cognitive science and behavioral sciences. And probably we think of
people like Aaron Beck or Albert Ellis as people who have been leaders
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Carlson: So there really is not any one group that it doesnt really
work with, but it seems to Its the challenge of the therapist to
Meichenbaum: Yeah, well, let me, let me sort of convey that, you
know, Im not only a clinician; Im also an academic. So the database
for these procedures are perhaps more developed in certain arenas
than others. And there are clearly difficult and challenging patients,
and they represent a challenge for every particular approach including
cognitive behavioral, and we can talk about the features and what
makes someone challenging but, you know, I Cognitive behavior
mod is not a panacea. Theres no miracle cures. It is a scientifically,
empirically based approach that grows out of an understanding of the
difficulties that clients have and their resources. And its growing.
Kjos: You talked about that, the therapist being able to modify. Just
how would that work? I mean, how would you give us an example of
how that might work where you would modify
Carlson: Or tailor.
Kjos: or tailor your treatment?
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Meichenbaum: Yeah.
Carlson: Its not a one size fit all approach, is what it sounds like.
Meichenbaum: Absolutely. Let me, let me go back and answer
it in this way: in my recent writings and especially when Im
teaching workshops, Ive tried to figure out what are the core tasks
of psychotherapy that cuts across all approaches? You know, what
are the key elements that lead to therapeutic benefits? And once
we understand what those core tasks areand perhaps well have
a chance to talk about itthen what you can do is alter those core
tasks culturally or in a sensitive fashion. So therapeutic alliance and
relationships are key.
Carlson: Would that be like the Maybe you could go over those core
tasks.
Meichenbaum: Okay. And if I just quickly give you a sense of those,
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then we can come back and I can show you how we can alter that or, to
use your word, tailor it. Okay?
Kjos: So therapeutic alliance.
Meichenbaum: Let me backtrack.
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You guys are in the business of making a lot of tapes. Youve had lots
of people go through this kind of process. And the key question is
youre in the business of identifying experts. So what is it that expert
therapists do? What do we know from the psychotherapy outcome
literature that cuts across so-called theoretical perspectives?
Well, the first thing that we know in terms of outcome is that the most
important variable in influencing outcome are patient characteristics.
So if you want to be successful as a therapist, you want to get invited
to this, the key thing that youve got to do is to select your patients
carefully. I mean, thats a very important thing. So I can give you an
enumeration of biological disorders, Axis II disorders, noncompliant,
treatment-resistant, that if you could exclude those, you would have a
rich and rewarding life. You would be invited to make these films.
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But most therapist
Carlson: You think hes told us the key to success? Okay.
Kjos: I think we got it.
Meichenbaum: No, but what it does is it highlights that most
therapists dont have that ability to select. So the key question is what
is it that therapists can control? From my reading of the literature, the
most important predictor of outcome is the quality and nature of the
therapist relationship, the ability to develop an alliance. And youll see
how much time I spend in the session in generating the empathy, the
genuineness, the nonjudgmental supportive fashion. I think that thats
common across all cultures and religions: people need to feel that
theyre understood, that theyre respected and heard.
A second kind of element in all therapy is that inherent in every
therapy is some kind of education. And its not didactic in terms of
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that the task of therapy isnt only what you get here, but how do you
build in generalization out there?
Two last tasks.
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Its not only important that people change; its critical that they take
credit for the changes. All the data indicates that people making selfattributions, attributing the change to something that they do, is
important. And thats even true in terms of research on medication.
Its not that the medication caused your depression to go away. Its the
medication allowed you to notice, to catch and interrupt.
Carlson: Gave you a leg up.
Meichenbaum: Not only that, the last itemand I dont mean to go
on so much, but once, I think, Ive put these before us, well be able
to come back and revisit your questionand that is it does relapse
prevention. It identifies that many of the problems people have are
episodic, that theyll occur again and again. And when we deal with
trauma, there may even be anniversary effects.
So what have I said? Expert therapists go through these activities.
Now, let me just pause and get your reactions to that, and then I can
go back and say, how would you implement those tasks differently if
you had different cultural, racial groups?
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Carlson: Or just tailor it for any kind of a specific problem.
Meichenbaum: Or populations. Does that make
Kjos: Or a couple or a family or an adolescent or
Meichenbaum: Right. Let me get your reactions. Why do you make of
my enumeration?
Carlson: It makes a lot of sense to me. I especially like the last point
that you raised, the relapse part, because we tend to front-load too
much of our treatment. And so many people get help and then two
years later theyre right back where they started from because we dont
show them how to continue to maintain the gains.
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this occurs over the course of time. And each of those particular core
tasks need to be attended to.
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I mean, I could take it to any population. If you want to go to the
eating disorder, you need to be cognizant that theres a high likelihood
of victimization among individuals who have eating disorders. Thats
a very high likelihood. Therefore, as you get the story you need to be
sensitive to give permission to let that portion of the story emerge if
indeed thats the case.
Or, and you know, theres lots of different directions I could go. Ill let
you sort of focus me in.
Carlson: Yeah. No, thats really a good example, though. I mean, just
showing some of the various components that you need to think about
as youre tailoring.
This whole notion of cognitive behavioral therapist in you, you know,
therapy, you indicated 30 years ago is really when you got started, but
thats probably the time that cognitive behavioral approaches really
got going. How did you get into this yourself?
Meichenbaum: There are different answers to this. I can give you the
academic and scholarly one and I can give you the more personal one.
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Carlson: Lets have, lets have Yeah, lets have
Kjos: Lets go for the personal.
Carlson: Number, number two.
Meichenbaum: Well, you know, I recently wrote a chapter in a book
called The History The Journey of a Psychotherapist and His
Mother. Kind of interesting. And
Carlson: I think he came from an analytical place, but lets go on.
Meichenbaum: No, its an, shes an My mothers Adlerian.
Kjos: His mothers Adlerian.
Meichenbaum: Id just like you to feel confident that he didnt die in
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vain, you know. That achievement motivation was a big piece of her.
So the question was, you know, where does the origin come? This
was written for undergraduates, right? So what do I tell the story? I
said, look. Let me tell you about my mother. Shes a very interesting
woman. She comes to visit me. She lives in New York. I live in Canada.
She comes to visit me, and each time she comes to visit me, shes full
of stories. Shes a big storyteller.
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But my mother has a particular, interesting way of telling stories,
because not only does she tell what happens to heryou know, shes
at work and some woman asks her to help move some boxes and she
knows she shouldnt move the boxes with her back and so forth and
she starts moving the boxes. And when she goes in with the box, she
comes back, the womans gone but the other boxes are there, you
know. And she starts to tell you this story about how she sort of got
entrapped out of her altruistic spirit to help. And then what happens
is she starts to get down on herself, she says. And not only does she get
down on herself, in she tells the story, she also comments about how
that was a bad thought to have: I mean, its bad enough I volunteered.
Now why should I get down on myself. And then I decided, Flo, stop
it, okay?
And it dawned on me that shes telling me this story
Kjos: Shes teaching you.
Meichenbaum: Not only that, it dawns on me that I ate dinner
with this woman every single night, and during the course of my
socialization process, I would hear her.
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So not only would she say, How was your day, Don? How was
school? And what did you think of the teacher? Now what led you
to think that? You think, how did you know that she meant to pick on
you? Maybe she
So what I have recognized is that my entire professional career is to
validate my socialization process.
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So therefore, cognition is not only the automatic thoughts and beliefs,
but they started to recognize that youre dealing with the nature of the
schemas. Now, as soon as cognitive behavior therapists got into that
window and recognized the critical role that feelings play, because
its, you know, thoughts influence feelings but feelings also influence
thoughts. As soon as they did that, it opened up a new window and
started to look like very psycho-dynamically oriented therapies. And
youll see that. The other and its very historical.
The other piece that became apparentand this grew out of a lot of
my work with trauma patientsis I, Ive become more and more a
constructivist. Ive described my work, and for anyone who wants it,
they can go on the internet and call up Meichenbaum and see various
interviews that Ive done that describe this in more detail.
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To see a kind of constructive narrative perspective that the way in
which we behave, the way in which we feel and appraise the world
is a large derivative of the stories we tell ourselves. So I see cognitive
behavior mod as a highly integrative therapeutic approach so that we
wont have a hundred different therapies, that were going to develop a
more theoretically based intervention.
Kjos: In a few minutes, were going to watch a demonstration of
you working with a young woman, and what were your goals in this
interview? What were you thinking about?
Meichenbaum: Not to do anything that would embarrass me.
Carlson: Sure.
Meichenbaum: No, I, you know
Carlson: For all time.
Meichenbaum: You are stuck on tape I mean, part of the challenge,
and the goal is, because Ive done films like this, is to implement as
many of those tasks as possible within the 45 minutes.
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So I needed to A) hear their story. I needed to develop a therapeutic
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Carlson: Its condensed. Its condensed.
Meichenbaum: Yeah, I think thats what happens. Let me finally note,
in terms of the origins of cognitive behavior mod.
Kjos: Back to the beginning, go ahead.
Meichenbaum: Well
Carlson: Hes still talking to himself, you know that?
Kjos: Hes still talking yeah, I know.
Meichenbaum: I grew up in New York City. People in New York City
talk to themselves all the time. They get off the train and theyve got to
get from the train to their house without getting mugged, okay? So the
whole time youre going from the train to the thing, you go, Ill walk
down here. No, no. I wont. Look, those two guys. Ill stop over here.
Its not too bad. Look at the people. Ill walk over there.
Now what happens is, when you go to Canada and do that
Carlson: Uh-oh.
Meichenbaum: they call that cognitive behavior modification, and
you become very famous and get invited to do these kinds of things.
Kjos: There you go.
Carlson: Well, lets watch how it works.
Meichenbaum: Youve got it.
Kjos: Thank you.
Carlson: Thank you.
PSYCHOTHERAPY SESSION
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Meichenbaum: Beverly, is it okay if I call you Beverly?
Beverly: Sure, thats fine.
Meichenbaum: First of all, I want to start off by thanking you for
coming in and agreeing to do this project. Perhaps we could begin by
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having you tell me a little bit about what brings you here, how I can be
of help.
Beverly: Well, Ive been suffering some anxiety. I havent been able
to sleep at night. My thoughts are going wild. Some nervousness and
fears. Just, just a lot of, and on edge a lot, you know, and its interfering
with, like, my schooling and things like that and
Meichenbaum: Of these, where should we begin? Where do you
help me understand what youre
Beverly: Well, I could tell you a little bit about probably the main
cause of it, and my history a little bit.
Meichenbaum: Okay.
Beverly: My father is a manic-depressive, and hes been that way since
I was about 13 years old.
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We never had any kind of help or support during that time, so we
pretty much just lived with it, kept it within the family. I used to feel
it was my fault a lot, that he was the way he was. I blamed myself a lot.
And hes been off and on that way for most of his life since then, and
he has the cycles. I never really got to know who he was, you know, as
a father, because hes always been kind of a stranger to me.
About a year and a half ago, my mom passed away. She was his
primary caretaker. She finally had to put him into a nursing home
because it was just too much for her to handle. After she passed away, I
had to become his power of attorney and take over all, everything, the
responsibilities, and become his caretaker.
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Its been really hard because theres a part of me that just cant, doesnt
have all that love to do that, you know, I mean. Its a mechanical thing
Im going through a lot of times. Hes still very abusive on the phone.
He calls and tells me hes going to cut me out of his will. Theres never
any real appreciation. Theres never any thank-yous and Ive just got so
much, so much stress. And my brother and sister are out of state and
theyre pretty much staying that way: out of sight, out of mind.
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at lately: feeling really bad about burdening the people around me that
shouldnt have to be that, go through that.
Meichenbaum: Right. And in working with him or with others, what
kinds of solutions, if any, what kinds of things have you been able to
bring on to cope with all of this? Give me a sense of where youre at in
terms of
Beverly: Well, I tried to do everything I could for my father when he
requested things.
Meichenbaum: Okay.
Beverly: But I was just getting beat up by him. Anything, nothing
I did was ever right or anything, or appreciated. So lately Ive been
distancing myself from him. When the phone rings, I dont answer it.
Hes getting more and more aggravated because of it.
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Im thinking maybe if I just dont be so accessible to him, maybe he
will stop it. But because hes mentally ill, he forgets a lot of things Ive
said or he brings up
Meichenbaum: So when he calls and is demanding and abusive,
can you remind yourself that hes mentally ill, that this is the illness
speaking?
Beverly: You know, I have a hard time with that, and I dont know
why. I mean, I think when I was growing up, my mother used to say,
couldnt believe that he was always that way. She used to say that he
was putting on an act. So I think theres that voice. I still hear that
and I wonder about that myself and I cant separate Because I never
know who he really is. I dont know who, if he was ever normal.
So I fight that. I do go back and forth between, yes, hes my father and
I, and I need to care for him. But yet, then hes a stranger, too.
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Meichenbaum: Tell me what it was like to grow up there during that
whole period.
Beverly: I was very lonely. I really shut down. I was always in fear. I
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didnt feel like I could reach out to anybody. My mother worked a lot
and he wasnt working, so he was home a lot. So we would have to deal
with him, my sister and my brother and myself. Or call her up and tell
her different things or shed call home and check.
Meichenbaum: And you were the oldest.
Beverly: I was the oldest.
Meichenbaum: So did the responsibility, more of the responsibility
fall on your shoulders then, too?
Beverly: Its possible because I stayed home longer than the other kids.
They left at about 20, and I stayed for a while longer thinking I could
help out, help my mother, I think.
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Try to be supportive. And it was never I started doing things for
her that she wanted done. Like Id take clothes to him at the mental
hospital, things she didnt want to do. Called the police a couple times.
Meichenbaum: You used, you mentioned something beforeand talk
about it only if you feel comfortableyou said something about his
sexual Some Some of the behavior that
Beverly: Yeah, its His, his, the way he would talk. He had
magazines around, that were like, he would just leave laying around.
One time, I was in the room and he came in the room and he shut
the door with me in there. And that, and I, you know, I dont think
anything happened but I always wonder, I go back sometimes and I
just start thinking, you start wondering how, if there was something
really traumatic that really might have happened. But my mom came
and hit the door so hard, I, she almost broke the door down.
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And nothing happened, I dont think, but it was so frightening.
Meichenbaum: How old were you then?
Beverly: About 15 or so, 14.
Meichenbaum: And how old are you now?
Beverly: 44.
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Meichenbaum: And did you, as you think back on it, feel threatened
or did you, I mean, what was going on then?
Beverly: I was always afraid. Yeah. I was always on edge. I never
relaxed, I dont think. I was always waitingbecause he was manic,
youre always watching to see what his moods are going to be, because
its, you know, it just kept getting worse and worse. And my mom
never wanted to get help, really, or just, until it was so bad. So we
watched it, you know, get worse and worse.
Meichenbaum: Was he aggressive with people in the home? Did he hit
people?
Beverly: The home? Where hes at now?
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Meichenbaum: With the family.
Beverly: Yeah, a couple times. Hes, he slapped my brother and hes
threw things, and I think he hit my mom once, maybe threw her
down.
Meichenbaum: And toward you?
Beverly: Not that I remember. Just very, very loud and screaming and
stuff. But I never knew if he was going to. I was so scared, I never knew
what he would do next, so I always lived in fear.
Meichenbaum: And are there other kind of incidents that you
remember during that time?
Beverly: Well, there are just so many things. I mean, it just kind of was
a blur, you know. Its hard to separate them.
Meichenbaum: One right after another?
Beverly: Yeah, it was like. Yeah, they never seemed to ease up. He
would go the other way, then he would get real withdrawn and then he
would shut himself off from everybody, too, that way, so then you had
the opposite, that he would become very remote.
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Meichenbaum: And what do you think lingers from that? What has
been the impact on you of all of that, that kind of experience?
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Beverly: I dont know. I try to think of the good times, and thats what
I, sometimes my thoughts are, because I want to hold on that hes not
all that bad. So from, when I was very young, I remember those good
times, and I guess I do that because I just dont want him to think that
hes so terrible.
Meichenbaum: So youve got to remind yourself of the good times?
Beverly: Yes. But now its getting harder and harder to do that. Now,
Im just, Ive almost put up a wall again, I think, with him.
Meichenbaum: Im curious what impact this has had on you in other
areas besides just dealing with your, with your dad. How does this
affect you in other ways?
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All of that.
Beverly: For a long time, I had a real problem with authority figures,
you know, and males. I could never have a relationship. They were
just Very shallow, you know, I could never I was afraid to, to
show my feelings, I think. I also Ive been told Im pretty smart, but
I kept that real quiet and I played dumb. Im not sure why I did that. I
guess he criticized me a lot and he was real sarcastic with me.
Meichenbaum: When you grow up with that kind of criticism,
growing up with being afraid and having to be vigilant, I wonder what
impact does it have when you, what
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What goes on from the constant exposure to that criticism?
Beverly: Im afraid to open up sometimes, I think. Im afraid to trust
people. Im just starting to get better at that, but for a long time, I was
just really, just didnt want to even try to reach out to people at all. So.
Because I was afraid theyd hurt me, I guess. Or criticize me.
Meichenbaum: As a result of all of that exposure to criticism, do
you ever get a sense that youve become your own critic in any way? I
mean, does that, does that concept
Beverly: Yeah. My voice, my heads always Yeah. I, I think
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Meichenbaum: I mean, given what youve experienced with him
over the years, given the lack of appreciation, given the absence of
support from your siblings, if you didnt have mixed feelings, some
ambivalence about caring for him, I would be deeply concerned. I
mean, youre still getting the criticism from him even though youre
doing a lot.
Beverly: I feel really bad in a way because I feel like he lost his wife,
too, you know, and I lost my mother, and I feel bad that hes lonely,
you know. And thats where I struggle because I would really like to be
with him and talk to him and just bond or something, you know, and
talk about what weve been through, our loss, the loss, and we cant
even do that.
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And so theres like, I dont know how to communicate with him. I
cant.
Meichenbaum: This is our only session together, okay, and if we had
subsequent sessions, let me give you a sense of where wed go and get
your reactions to this.
Beverly: Okay.
Meichenbaum: One thing that I would explore with you, okay, is
the stress youre experiencing with your dad and these other areas of
your life and how you can, perhaps, cope with that more effectively,
whether theres anything you can do with the siblings, whether theres
a way that you could share feelings so that it isnt a burden to your
husband, the way in which you might be able to bond with your dad,
the way in which you could remember the good times, and the mixed
reactions.
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So a lot of what we would do is sort of here-and-now problem solving
around that to find out what youve done and so forth.
Beverly: Okay.
Meichenbaum: And I would like you to make sure that your
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223
Beverly: Well, I think I just want to feel good about myself, you know,
that I can do what I want to do and not have to feel like everything
is him. But thats where I get torn, because, you know, theres this, a
little guilt comes in that I should, like, be there for him more. But I
have no energy left, you know, for him. And when I focus so much on
him, I just dont care about myself. And sometimes I just want to drop
out of life. And you know, like, whats the use? Just want to have more
energy, I think, for me, you know.
Meichenbaum: Tell me about this dropping out of life. What is, what
is that?
Beverly: I just feel like hopping in a car and just driving away, you
know, and just leaving everything behind.
Meichenbaum: Have you thought about hurting yourself or
committing suicide or anything like that, or is it just
Beverly: No, but I do get, you know, I can get depressed at times
where I just dont want to get up or, you know, I mean not lately or
anything.
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More so when I was like in my early 30s, I was going through some
very depressed times.
Meichenbaum: Are you concerned at times about being, having a
similar kind of condition like your dad?
Beverly: Ive wondered about it. I dont think I get that ecstatic high
that he gets, but I can get, you know, get down to the lows sometimes.
Meichenbaum: You could see yourself being depressed?
Beverly: Uh-huh.
Meichenbaum: Have you ever been on medication for the depression?
Beverly: Uh-uh.
Meichenbaum: Have you see anyone about, for the depression in
terms of therapy?
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Beverly: Ive seen people in, for therapy but never like for the
medication.
Meichenbaum: No, no. I meant just to deal with the depression. Have
you seen anyone to talk about that?
Beverly: Yeah, Ive talked to some therapists.
Meichenbaum: Has that helped you?
Beverly: Yeah, its basically been just like, its a release for me, but
its, I mean, I dont know if Im looking for answers or something
sometimes, you know, to, how to get out of it.
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What I do is just talk the whole time and that person listens. So its a
release.
Meichenbaum: But have they talked to you about ways that you can
cope with the depression?
Beverly: Not really.
Meichenbaum: Notice it, the way in which you often engage in
shoulds and the impact of that should?
Beverly: Not too much. They usually just kind of repeat pretty much
what Im saying.
Meichenbaum: Well, tell, tell me about the shoulds. Because you
know, you should bond: you should have positive feelings toward him.
Beverly: I shouldnt feel, be feeling angry at my father.
Meichenbaum: Right.
Beverly: I should love him.
Meichenbaum: Yeah, come on. Give me the list. Get it out.
Beverly: I should, I shouldnt be depressed. I should be happy, I should
love life.
Meichenbaum: Right. Well, come on.
Beverly: I should have all these friends. I should be out doing things. I
shouldnt be sitting home.
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used in therapy, and I dont know if any of your other therapists have
done it, is theres a kind of strategy thats sometimes used almost like
an empty chair, its like a Gestalt thing, where you put your father
there and you tell him, even in this imaginal scene how you feel, what
the anger is.
Beverly: I could do that. I think I could do that. Id be afraid,
probably, though.
Meichenbaum: Well, well try it. Imagine I cant get out of the
empty chair because of the cameras but imagine that he was here.
What would you say to him? Try it.
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Beverly: I would just say, You were never there for me and you expect
me to be there for you now. You never loved me. You never wanted
me. You just treated me like shit my whole life. All youve cared about
is yourself; youve never cared about anybody else. You know, your
wife died because of the stress you put her through. So you know, and
yet, youre always coming out smelling like a rose. And were always
looking, you know, were always crap. And I just, Im just tired of it.
Im just tired of the way you are, you know. And I think youre hiding
behind that illness sometimes. You know, sometimes I think thats a
cop out and thats why I cant believe in the illness sometimes.
230
Meichenbaum: And how does that make you feel? Tell him how it
makes you feel.
Beverly: It makes me feel good.
Meichenbaum: To say that?
Beverly: I dont know. Its hard to get to that anger.
Meichenbaum: No, no, tell me, tell him Stay with the anger. I want
you to tell him, tell your dad just how angry you are. What was it like
to grow up there? When he closed the door, when your mother was
banging on the door and you were in there, when you were being
vigilant?
Beverly: It just felt awful, you know. I was just so lonely and so scared,
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and you just shut me out, you know. You just didnt care and you
didnt care what you did to anybody. You didnt care if we were crying
or we were screaming or, you just didnt care. You just kept it up, more
and more, you know, and it was just like, I just felt like you did it on
purpose sometimes. Like that was really who you were, that you just
were a mean person.
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You still are. Youre not changing. You want everybody to feel sorry
for you. And you dont care about anybody else, and its like, and if
you, nobody does what you want, you just cut them off. And Ive just
had it. Im just tired. Ive tried to, Ive tried to be somebody for you,
a daughter or something, and I just cant even see you as being my
father. There is no father there. Youve just hurt me my whole life.
Meichenbaum: Am I still hurting you?
Beverly: Yes, you still are.
Meichenbaum: Tell me about the hurt that youre now feeling.
Beverly: I dont know. It just, you just treat me like Im, Im a stranger,
like Im not your daughter.
Meichenbaum: And how does that make you feel?
232
Beverly: It just makes me feel like youre using me or something, you
know? That you never cared and you never will. I thought you would
care. I thought you would change. And it looks like youre never going
to and I just, Im just tired of trying.
Meichenbaum: So if Im not going to changeyour dadtell me how
youre going to change.
Beverly: Well, I just feel like Im just kind of like, right now, Im just
running, just cutting, cutting myself off from you. Im tired of doing
for you and youre not doing anything back. I dont know if its always
got to be a give and take, but its always been a give from me to you. So
I just feel like I have to give it back to myself for a while.
Meichenbaum: And tell me what it means to give it back to yourself.
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people who grow up in homes when theres severe mental illness and
what lingers from that. And the portion of the tape that we didnt
get to in terms of your story is what youve been able to accomplish
in spite of growing up in that home, in terms of your marriage, in
terms of your smarts, in terms of your schooling. And I would want to
explore how you were able to accomplish all that you did and have the
courage to make this tape in spite of that, and thats the portion that
we didnt get to.
242
Let me get your reactions to how
Beverly: I felt good. I felt real emotional. I mean, I didnt think I
would feel emotional because I was thinking it would be so cognitivetype, thinking, and it would be rational and stuff. But I was able to
feel real emotional, and I felt real safe with you.
Meichenbaum: Good. Thats important.
Beverly: And I didnt know how I would feel with a male person
because Ive got a real problem with that. I was thinking about that
before I got here, you know, trusting authorities and especially males.
So that was good. Im glad that I was able to deal with that. Its kind of
a breakthrough, I think.
Meichenbaum: Yes.
Beverly: And just to tell my story was good. I just need to keep
Meichenbaum: And how did this role playing with the dad kind of
thing, how did that
Beverly: It was kind of scary, but I probably have a lot more inside. I
could have really probably really
243
Meichenbaum: Let loose.
Beverly: I was holding back, I think.
Meichenbaum: Right.
Beverly: But it was a start, I think, and I think that maybe if I keep
trying it without, with just a totally empty chair, I think I need to do
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Video Credits
SPECIAL THANKS TO:
The clients for their time and the courage to share their personal
stories so others may learn.
Frank Couglin, Project Coordinator, for his dedication to the success
of this project.
Faculty and students in the Psychology and Counseling Division of
the College of the Education at Governors State University.
Diane Alexander, Dean, and Addison Woodward for their support
and encouragement.
Leon Zalewski, former Dean, and Larry Freeman, Acting Dean,
College of Education for their support and encouragement.
A very special thank you to Ray Short, Editor, for his courage and
vision. Also, to Virginia Lanigan, Stephen Smith, and David
Sacchetti at Allyn & Bacon.
A production of Communications Services,
Governors State University.
Video copyright 2000, Allyn & Bacon
DVD released by Psychotherapy.net, 2009
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Notes
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MANUAL AUTHORS
Randall C. Wyatt, PhD, Editor-in-Chief of Psychotherapy.net,
is Director of Professional Training at the California School of
Professional Psychology, San Francisco at Alliant International
University and a practicing psychologist in Oakland, California.
Erika L. Seid, MA, LMFT, Educational Programs Manager at
Psychotherapy.net, is a practicing psychotherapist in the San
Francisco Bay Area, specializing in cultural issues and sexual offender
treatment.
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65
Harville Hendrix
Evan Imber-Black
Arnold Lazarus
Steve Lerner
Ronald Levant
Hanna Levenson
Rollo May
Monica McGoldrick
Donald Meichenbaum
Scott Miller
Jacob Moreno
Zerka T. Moreno
Rod Mullen
Frank Ochberg
George Papageorge
Erving Polster
Ron Scott (Producer)
Martin Seligman
Lenore Walker
Irvin Yalom
Harville Hendrix on
the Healing Relationship
Family Secrets
Arnold Lazarus: Live Case Consultation
Shes Leaving Me
Effective Psychotherapy with Men
Time-Limited Dynamic Psychotherapy
Rollo May on Existential Psychotherapy
The Legacy of Unresolved Loss
Mixed Anxiety and Depression:
What Works in Psychotherapy
Moreno Movies (4-DVD series)
The Zerka T. Moreno Series (3-DVD series)
Encounter Groups for Addictions
(3-DVD set)
PTSD and Veterans
Connecting with Our Kids
Psychotherapy with the Unmotivated Patient
Psychotherapy with Gay, Lesbian and
Bisexual Clients (7-DVD series)
Positive Psychology and Psychotherapy
The Abused Woman
The Gift of Therapy
Irvin Yalom: Live Case Consultation
Understanding Group Psychotherapy
(3-DVD series)
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